To diagnose binge-eating disorder, your medical care provider may recommend a psychological evaluation, including discussion of your eating habits.
Your medical care provider also may want you to have other tests to check for health consequences of binge-eating disorder, such as high cholesterol, high blood pressure, heart problems, diabetes, GERD and some sleep-related breathing disorders. These tests may include:
- A physical exam
- Blood and urine tests
- A sleep disorder center consultation
The goals for treatment of binge-eating disorder are to reduce eating binges and achieve healthy eating habits. Because binge eating can be so entwined with shame, poor self-image and other negative emotions, treatment may also address these and any other mental health issues, such as depression. By getting help for binge eating, you can learn how to feel more in control of your eating.
Whether in individual or group sessions, psychotherapy (also called talk therapy) can help teach you how to exchange unhealthy habits for healthy ones and reduce bingeing episodes. Examples of psychotherapy include:
- Cognitive behavioral therapy (CBT). CBT may help you cope better with issues that can trigger binge-eating episodes, such as negative feelings about your body or a depressed mood. It may also give you a better sense of control over your behavior and help you regulate eating patterns.
- Interpersonal psychotherapy. This type of therapy focuses on your relationships with other people. The goal is to improve your interpersonal skills — how you relate to others, including family, friends and co-workers. This may help reduce binge eating that's triggered by problematic relationships and unhealthy communication skills.
- Dialectical behavior therapy. This form of therapy can help you learn behavioral skills to help you tolerate stress, regulate your emotions and improve your relationships with others, all of which can reduce the desire to binge eat.
Lisdexamfetamine dimesylate (Vyvanse), a drug for attention-deficit hyperactivity disorder, is the first FDA-approved medication to treat moderate to severe binge-eating disorder in adults. A stimulant, Vyvanse can be habit-forming and abused. Common side effects include a dry mouth and insomnia, but more-serious side effects can occur.
Several other types of medication may help reduce symptoms. Examples include:
- Topiramate (Topamax), an anticonvulsant. Normally used to control seizures, topiramate has also been found to reduce binge-eating episodes. However, there are side effects, such as dizziness, nervousness, sleepiness and trouble concentrating, so discuss the risks and benefits with your medical care provider.
- Antidepressants. Antidepressants may reduce binge-eating. It's not clear how these can reduce binge eating, but it may relate to how they affect certain brain chemicals associated with mood.
While these medications can be helpful in controlling binge-eating episodes, they may not have much impact on weight reduction.
Behavioral weight-loss programs
Many people with binge-eating disorder have a history of failed attempts to lose weight on their own. However, weight-loss programs typically aren't recommended until the binge-eating disorder is treated, because dieting may trigger more binge-eating episodes, making weight loss less successful.
When appropriate, weight-loss programs are generally done under medical supervision to ensure that your nutritional requirements are met. Weight-loss programs that address binge triggers can be especially helpful when you're also getting cognitive behavioral therapy.
Lifestyle and home remedies
Typically, treating binge-eating disorder on your own isn't effective. But in addition to professional help, you can take these self-care steps to reinforce your treatment plan:
- Stick to your treatment. Don't skip therapy sessions. If you have a meal plan, do your best to stick to it and don't let setbacks derail your overall efforts.
- Avoid dieting, unless it's supervised. Trying to diet can trigger more binge episodes, leading to a vicious cycle that's hard to break. Talk with your medical care provider about appropriate weight management strategies for you — don't diet unless it's recommended for your eating disorder treatment and supervised by your medical care provider.
- Eat breakfast. Many people with binge-eating disorder skip breakfast. But, if you eat breakfast, you may be less prone to eating higher calorie meals later in the day.
- Arrange your environment. Availability of certain foods can trigger binges for some people. Keep tempting binge foods out of your home or limit your exposure to those foods as best you can.
- Get the right nutrients. Just because you may be eating a lot during binges doesn't mean you're eating the kinds of food that supply all the essential nutrients. Ask your medical care provider if you need to adjust your diet to provide essential vitamins and minerals.
- Stay connected. Don't isolate yourself from caring family members and friends who want to see you get healthy. Understand that they have your best interests at heart.
- Get active. Ask your medical care provider what kind of physical activity is appropriate for you, especially if you have health problems related to being overweight.
Most dietary supplements and herbal products designed to suppress the appetite or aid in weight loss are ineffective and may be misused by people with eating disorders. And natural doesn't always mean safe. Weight-loss supplements or herbs can have serious side effects and dangerously interact with other medications.
If you use dietary supplements or herbs, discuss the potential risks with your medical care provider.
Coping and support
Living with an eating disorder is especially difficult because you have to deal with food on a daily basis. Here are some tips to help you cope:
- Ease up on yourself. Don't buy into your own self-criticism.
- Identify situations that may trigger destructive eating behavior so you can develop a plan of action to deal with them.
- Look for positive role models who can help lift your self-esteem. Remind yourself that the ultrathin models or actresses showcased in women's magazines often don't represent healthy, realistic bodies.
- Try to find a trusted relative or friend whom you can talk with about what's going on.
- Try to find someone who can be your partner in the battle against binge eating — someone you can call on for support instead of bingeing.
- Find healthy ways to nurture yourself by doing something just for fun or to relax, such as yoga, meditation or simply a walk.
- Consider journaling about your feelings and behaviors. Journaling can make you more aware of your feelings and actions, and how they're related.
If you have binge-eating disorder, you and your family may find support groups helpful for encouragement, hope and advice on coping. Support group members can understand what you're going through because they've been there themselves. Ask your medical care provider if he or she knows of a group in your area.
Preparing for your appointment
Treatment of binge-eating disorder may require a team approach that includes doctors and other medical care providers, mental health professionals and dietitians with experience in eating disorders.
Here's some information to help you get ready for your appointments. Ask a family member or friend to go with you, if possible, to help you remember key points and give a fuller picture of the situation.
What you can do
Before your appointment make a list of:
- Symptoms you're experiencing, including any that may seem unrelated to the reason for your appointment
- Key personal information, including any major stresses or recent life changes
- All medications you're taking, as well as any herbs, vitamins or other supplements, and their dosages
- A typical day's eating, which can help your medical care provider or mental health professional understand your eating habits
Questions to ask your medical care provider or mental health professional include:
- What treatments are available, and which do you recommend?
- If medication is a part of treatment, is a generic drug available?
- Are there any brochures or other printed material I can have? What websites do you recommend?
Don't hesitate to ask other questions during your appointment.
What to expect from your doctor
Your medical care provider or mental health professional is likely to ask you a number of questions, such as:
- What does your typical daily food intake look like?
- Do you eat unusually large amounts of food or until you're uncomfortably full?
- Do you feel your eating is out of control?
- Have you tried to lose weight? If so, how?
- Do you think about food often?
- Do you eat even when you're full or not hungry?
- Do you ever eat in secret?
- Do you feel depressed, ashamed or guilty about your eating?
- Do you ever make yourself vomit to get rid of calories?
- Are you concerned about your weight?
- Do you exercise? How often?
Your medical care provider or mental health professional will ask additional questions based on your responses, symptoms and needs. Preparing and anticipating questions will help you make the most of your appointment time.